An oncologist's prescription for managing fear and chaos in the COVID-19 pandemic

Here are the stories you missed on KevinMD. Thank you for your continuing readership. --------------------------------------------------------------- Here are the stories you missed on [KevinMD](. Thank you for your continuing readership. --------------------------------------------------------------- Sponsors [From code calls and critical test result alerts]( to provider-to-provider communications, efficient and timely notifications can speed care and improve clinical outcomes. Learn four strategies to streamline hospital code calls and [improve communications support for your staff and your patients](. As physicians and practices ramp up [providing patient care via telehealth]( during the COVID-19 pandemic, practical challenges and questions related to technology, regulatory restrictions, and [potential liability are surfacing](. [During COVID-19]( physicians turn to telehealth to deliver care while reducing risk. Learn strategies to meet the need for [quick change and continuity of care](. Physicians and practices are using remote patient monitoring (RPM) devices to care for [Medicare patients with chronic conditions during COVID-19](. Improve outcomes while earning robust reimbursement. [Learn more](. --------------------------------------------------------------- KevinMD Plus: Apr 16, 2020 [An oncologist’s prescription for managing fear and chaos in the COVID-19 pandemic]( When physicians present at medical conferences, we usually start with a slide disclosing any potential conflicts of interest to our audience. I probably need to disclose two things here. First, I’m an infuriating and inexhaustible optimist. Second, I’m a cancer doctor but also a recent cancer patient myself, and I understand intimately how it feels […] [A letter from a pulmonary physician on the sidelines]( I write to the health care workers and other essential hospital personnel who are at the center of efforts to care for our neighbors during the novel coronavirus pandemic. I am a pulmonary specialist and critical care physician. I am trained to manage organ failures, including diseases of the lung that require life support with […] [A medical student about to graduate. And a lack of closure.]( In this isolated and new existence, we are experiencing a collective grief. A deep, poignant distress caused by bereavement. Apart physically, but together mourning the loss of the world we once knew. Life has distinct stepping stones. Birth, death, marriage, graduation. Proof that one phase of existence has ended, and another will soon begin. Traditionally, […] [When the pandemic became real to this physician]( Everything feels like it’s happening out of a movie, mostly because we’ve all seen it before. Pandemic, Outbreak, even World War Z. It has never felt real, until it became real. It became real when all of my friends from my pediatrics residency in New York became adult doctors, figuring out how to ventilate a […] [The moral and ethical dilemmas of COVID-19]( In all of my thirty years of medical practice, I have never encountered the degree of moral and ethical dilemmas as those created by COVID-19. None of us has experienced anything like this. At no time in our history has all of humanity been at risk for contracting the same potentially deadly disease. And never […] [Should fourth-year medical students graduate early?]( Graduating medical students early is not a completely novel concept. During WWII, there was a significant physician shortage, and various medical schools initiated a 3-year accelerated MD program to produce more physicians. These programs were eventually discontinued in the late 1970s and early 1980s. In 1918, the influenza pandemic created a similar situation. Third- and […] [The importance of achieving FIRE for the physician in the age of COVID-19]( Times have definitely changed. In the month of March 2020, we have seen the global economy shut down almost completely. Businesses shut down. Travel stopped. Millions filing for unemployment. Crises that used to span out over months, now happen in the time span of weeks to days. The rate of economic decline from COVID-19 is faster, […] [Treating COVID-19 patients in their homes]( Anecdotal though it may be, a team of Italian doctors and nurses, led by Dr. Luigi Cavanna, has reported apparent success treating COVID-19 patients in their homes. Realizing too many near-death patients were traveling long distances to the hospital emergency room in Piacenza, Italy from their rural villages, Cavanna reasoned many of these patients might […] [The collective consciousness of COVID-19]( “Plagues are infrequent but constant, and they do not alter the conditions of mankind (everybody dies) but rather concentrate our misfortunes into moments where everyone thinks for a change that mortality is afoot.” – Albert Camus In Camus’ construct, there was no mass media or the internet, yet the fear of imminent death spread like […] [Coping with fear as a physician during a pandemic]( Throughout my years as a physician, I have had an abundance of moments of fear. Typically, this fear has been related to concern for my patients. A fetal bradycardia requiring an emergency Cesarean section, a postpartum woman hemorrhaging despite all first line medications and procedures, a woman with a ruptured ectopic pregnancy and dropping hemoglobin. […] [Addressing the social isolation problem one step at a time]( As chief resident of my rural Hawaii Island Family Medicine Residency program, I look back with our nation upon the past four months that turned our whole world topsy-turvey. At the start of this year, I remember when leaders of organizations, businesses, and churches started sharing their new “2020 visions” for a year of great hope […] [The impact of removing numerical scores from USMLE Step 1]( I recall clearly the effect that the first step of the United States Medical Licensing Exam (USMLE) had on my medical education. The test is generally taken at the end of the second year of medical school, about halfway through the 4-year curriculum. What made the test so important is that its result could effectively […] [The struggle of being a nurse is real]( As I struggled my way through nursing school, I never expected my first job as a nurse to feel like this; I was too busy dreaming of the day when I could hold the title of registered nurse. I never expected to come home crying. I never expected that, at times, I’d mumble the words […] [Do viruses infect bones?]( Viruses typically invade our bodies through an opening. Think gastrointestinal flu, COVID-19, AIDS. Our bones, however, are normally protected from any outside exposure, so they should be safe, right? The short answer is yes and no. Of course, knowledge is power, and we need both right now, so here is a nuanced answer. Patients with smallpox frequently […] [Cowardice in the face of coronavirus]( When coronavirus exploded, my family was on vacation in Colorado. We played the news nonstop, and it was frightening. I’m a control freak, a planner, and thus my worries were nonstop. What were other hospitals doing to prepare as compared to my own? What were the plans to ration PPE? How was the morale at […] [You’re just the anesthesiology resident]( You always knew they didn’t care about you. The administration, I mean. But you knew that going into it. It’s just four years that you have to endure until you can be respected, until you make the big bucks, until you’re treated like a human being. Four years is not that long. But you knew […] [How a physician finds laughter during this dark time]( As I write this, we are in dark times. Over 23,000 Americans have died from the coronavirus, and there are half a million diagnosed cases – even with testing far from comprehensive. Most cities are on some sort of lockdown. Most of us have become hyperaware of hygiene and personal space in a way that […] [Combating patient isolation: Breast cancer treatment during the COVID-19 pandemic]( As a health care system, we have united during the COVID-19 public health threat to embrace social distancing and “flatten the curve.” In order to conserve scarce resources and limit viral transmission, we health care providers have canceled elective surgeries, postponed health screenings, and moved patient encounters to online platforms. While we are fighting to […] [How nurses made me a more compassionate and caring person, and a better physician]( I have had the privilege to serve alongside hundreds of nurses in the nearly 40 years since I started medical school. This includes inpatient and outpatient settings and 20 years of leading medical missions around the world. There are five amazing nurses in my family as well. I have learned from every nurse with whom […] [What’s in a disease name, anyway? Everything.]( Spanish Flu. Japanese Encephalitis. Middle Eastern Respiratory Syndrome. West Nile Virus. Wuhan Virus (and lately, the “Chinese Virus” as many have begun calling the pathogen that causes COVID-19: SARS-CoV-2). What do these names all have in common, you might ask? Well, for one thing, they were constructed not by a strict scientific nomenclature, but by […] [The shift from a junior to a senior resident]( For physicians, residency is the most critical time for growth in clinical and surgical skills, professionalism, and medical knowledge. Your residency training — for better or worse — shapes your future career as a physician. Your surgical technique, clinical decision making, and bedside manner are all, to some degree, a reflection of where you trained. […] [Genetic testing: Could there be unintended consequences?]( Both clinical and direct-to-consumer genetic testing have become significantly less costly and more common, providing people with access to a wealth of information about everything from their ethnicity and family lineage to their risk for certain diseases and how they will respond to medications such as blood thinners and antidepressants. But before you decide to […] [Stolen checks and maybe some forgiveness]( It took some getting used to in dealing with Mae. My main function soon became acting as her bookkeeper. Each month, I would write checks for her. She was illiterate, and signing her name was about all she could do. Mae was a fairly ordinary looking lady past 50 by several years. But what was […] --------------------------------------------------------------- If a friend sent you this email and you want to subscribe, go to [KevinMD](. --------------------------------------------------------------- 345 Hudson Street New York NY 10014 USA [Unsubscribe]( | [Change Subscriber Options](